William C. Moyers was a talented, aggressive journalist who never missed a deadline. He sang in his church choir and owned a home on Long Island. For years, he was a closet alcoholic and crack cocaine addict.
"I was physically, emotionally and spiritually bankrupt," he said Monday, May 8, at "On Addiction," the second in The Open Mind Series hosted by the Picower Institute for Learning and Memory and sponsored by CIGNA. "I wanted to die, but I didn't know how to do it," Moyers said. He said he hit rock bottom in 1989 when he was locked in a psychiatric ward in St. Vincent's Hospital in New York.
It took four separate treatments before Moyers "stayed quit." Now, 12 years sober and drug-free, he is vice president of external affairs at Hazelden, a nonprofit headquartered in Minnesota that runs private alcohol and drug rehabilitation centers.
Moyers and other panelists at the daylong MIT conference said that one of the biggest issues facing addiction treatment is the social stigma still associated with substance abuse. While neuroscience offers up new targets for potential anti-addiction drugs, pharmaceutical companies are reluctant to research and develop these drugs, according to panelist Dr. Nora D. Volkow, director of the National Institute on Drug Abuse.
Harvard neurobiologist Dr. Steven E. Hyman, former director of the National Institute for Mental Health; Dr. Robert C. Malenka, a Stanford psychiatry and behavioral sciences professor; and Dr. Wolfram Schultz, professor of neuroscience at the University of Cambridge in England, described the latest neurobiological findings related to addiction.
They pointed to studies that show that addiction changes synaptic connections in the brain in ways that are difficult, if not impossible, to "overwrite." These changes make the addict vulnerable to relapse years after the last exposure to the addictive substance, and occur in brain regions that make repeated cravings for the substance so compelling that the individual often cannot control his or her actions. The brain regions in which addictions take hold are the ones responsible for survival behaviors, making the need for a drug or alcohol akin to a quest for food, safety and other necessities.
Drugs such as cocaine and amphetamine masquerade as neurotransmitters that unleash dopamine. While the brain has ways to fine-tune dopamine levels, cocaine is too powerful for this delicate mechanism. The excess dopamine sets into motion a cascade of events that usurp the brain's innate reward-based system of learning and memory.
According to Susumu Tonegawa, director of the Picower Institute, it is particularly apt for the Picower Institute to partner with health insurance giant CIGNA on an exploration of addiction because addiction is "an extreme form of learning and memory."
Panelists also included Dr. Craig Coenson of CIGNA Behavioral Health; Steve Pasierb of Partnership for a Drug-Free America; and Dr. Shelly Greenfield of Harvard Medical School and McLean Hospital. The conference, which brought together diverse stakeholders to explore how insights gained from advanced study of learning and memory could be applied to addiction, was moderated by Ira Flatow, host of National Public Radio's "Science Friday."
Moyers urged recovered addicts and addiction researchers to speak out to end the stigma that is stalling potential treatments for addiction as a disease.
"It starts with people in recovery, but it doesn't end there," Moyers said. "If you are a person in recovery or a family member, go back and share that with someone in your community. If you are a researcher, explain to someone why you are committed to what you are doing. It is science that informs public policy; science has the awesome responsibility to smash the stigma."
A version of this article appeared in MIT Tech Talk on May 17, 2006 (download PDF).
